PHTY100Semester1Notes–SarahCrisafulli 1

PHTY100–PhysiotherapyAnatomy1 Learning Outcomes 1. Identifythefeaturesandfunctionsoftheindividualbonesofthelowerlimbandpelvis;

2. Classifyanddescribethestructures,functionsandmovementsofthejointsofthelowerlimb;

3. Explainindetailtheactionsandfunctionsofmuscles;

4. Describetheattachments,actionsandfunctionsofthemusclesofthelowerlimb;

5. Describetheformation,branchesandrelationsofthelumbosacralplexusandthecourseanddistributionofperipheral,somaticnerveslocatedintheglutealregionandlowerlimbs;

6. Describethestructureandfunctionofthevascularsupplyofthelowerlimb;

7. Demonstrateanunderstandingofstructureandfunctionofconnectivetissues,includingresponsetoimmobilisation,injuryandrepair;

8. Analysethemuscleactionsandjointmovementsthatoccurinfunctionalactivitiesinvolvingthepelvisandlowerlimb(ACUGraduateAttribute:criticalandanalyticalabilities);

9. Identifyanddescribethelocationofbonyprominencesandotherstructuresinthepelvisandlowerlimbthroughpalpation;

10. Analysethemusculoskeletalsystemofthelowerlimbsintermsofhowanindividualwithanimpairmentmaypresentclinicallyinaphysiotherapypracticesetting;

11. Demonstratesafeandcollaborativephysiotherapylaboratorypractices(ACUGraduateAttribute:communicationandinterpersonalskills).

Introduction to Anatomy and Osteology

1.1DefinethestandardanatomicalpositionSeeimage1.2DescribethefollowingtermsofpositionanddirectionDirectionaltermsinclude(othersindiagram):

• Superficial–closertotheskinsurface• Deep–awayfromskinsurface• Proximal–closertotrunk• Distal–awayfromtrunk• Ipsilateral–onthesameside• Contralateral–ontheoppositeside

ListthecomponentsofnomenclatureBonecellsBonetissue(cellsplusextracellularmaterial)Boneorgans(bonetissueplussomeothertissues)Skeletalsystem(collectionofboneorgans)

• Understandbasicanatomicaltermsrelatedtopositionanddirection

• Understandthedivisionsandfunctionsoftheskeleton• Classifybones• Describeandstatethefunctionsofbonemarkings• Identifyspecificfeaturesofthebonesofthehipandpelvisregion

PHTY100Semester1Notes–SarahCrisafulli 2

1.3ListthemajorbonescomprisingthetwodivisionsoftheskeletonAxialskeleton:Bonesofthevertebralcolumn,thorax,pelvis,skullAxialskeleton:Bonesofthelimbsandthelimbgirdles1.4Listfourfunctionsoftheskeleton

1. Calciumstorage2. Protectionfromexternalforces3. Efficientperformanceofmechanicalwork4. Withstandandrecoverfromtensileandcompressiveforces5. Productionofredandwhitebloodcells

Bone

• Almostequallyresistanttotorsional(bending)andcompressiveforceso Flexibility:organiccomponentso Strength:inorganiccomponents

• Arrangementofbonetissuereflectsfunctiono Osteons:compactbonetissuearrangesintightlypackedunitswhenhightorsionalstresso Trabeculae:spongybonetissuearrangedincrisscrosspatternswherecompressiveforceishigh

1.5Classifybonesaccordingtoshapeandgiveanexampleofeachtype1.6Describeandstatethefunctionsofbonemarkings(projectionsanddepressions)andfindanexampleofeachtypeofmarkingFunctionsofirregularitiesofbone:

− Strengthensbone− Providespassagesthroughthebone− Promotesbonetobonearticulation− Providesattachmentsites− Provideslandmarks

BoneMarkings DescriptionProjections Trochanter Roughenedbumpsformuscleattachment

TuberosityTubercleHead Smooth,forarticulationCondyleEpicondyle RoughenedareaaboveacondyleRamus BridgeofboneLine RaisedcrestsformuscleattachmentRidgeSpine

Depressions Facet Small,flat,smoothareausuallyforarticulationFovea SmallpitFossa SocketonaboneGroove ShallowfurrowSulcus DeeperfurrowForamen HolethroughaboneMeatus CanalinaboneCanal Fissure Slitthroughabone

PHTY100Semester1Notes–SarahCrisafulli 3

Sinus Cavitywithinabone,usuallyairfilled1.7Identifythepelvis–identifytheinnominate(hip)bones,sacrumandcoccyx1.8Identifyandclassifythehipbone,andidentifyitscomponentparts–ilium,ischiumandpubis1.9Ontheiliumidentify:iliacfossa,iliaccrest,glutealsurface,gluteallines(anterior,posterior,inferior),auricularsurface,iliactuberosityandiliacspines1.10Ontheischiumidentify:body,ramus,ischialspine,ischialtuberosity,andlessersciaticnotch1.11Onthepubisidentify:body,rami(superior,inferior),pubiccrest,pubictubercle,andsymphysealsurface1.12Identifyonthearticulatedpelvis:acetabulum,acetabularfossa,acetabularnotch,obturatorforamen,greatersciaticnotch,andischiopubicramus.1.13Statethecontributionoftheischium,iliumandpubisofeachfeaturenamedabove

§ Acetabulum:1/5pubis,2/5ischium,2/5ilium§ Acetabularnotch:ischium§ Greatersciaticnotch:ilium§ Ischiopubicramus:pubis(inferiorpubicramus)andischium(inferiorramusofischium)

PHTY100Semester1Notes–SarahCrisafulli 4

• Understandthedefinitionofajointanddescribeasystemforjointclassification• Understandthetermsusedtodescribemovementanddemonstratemovementatselectedjoints• Understandthestructureandfunctionofthecomponentsofsynovialjoints• Identifythegrossanatomicalstructuresofthehipjoint• Describethefunctionalanatomyofthehipjoint

1.14Identify,classifyandorientatethefemur1.15Onthefemuridentify:→ Proximalend–head,neck,

foveacapitis,greatertrochanter,lessertrochanter,intertrochantericcrest,quadratetubercle,trochantericfossa,intertrochantericline

→ Shaft–pectinealline,glutealtuberosity,lineaaspera,medialandlateralsupracondylarridges

→ Distalend–medialandlateralcondyles,medialandlateralepicondyles,adductortubercle,intercondylarfossa,poplitealsurface,patellasurface

1.16Ontheproximalendofthetibiaidentify:tibialplateau,medialandlateralcondyles,intercondylareminence,fibulararticularfacet,tibialtuberosity

Introductory Arthrology and the Hip Joint 2.1Definethetermjoint

§ Aunionbetweentwoormorepartsoftheskeleton§ Classifiedby:structure(fibrous,cartilaginous,synovial)andamountofmovementavailable(immovable,slightlymovable,

freelymovable)- Jointsdescribedby:Classification,movementandaxes,ligamentsandmechanicalfunctions,articulardiscsandmechanicalfunctions,bursaandlocations,descriptionofstructuresprovidingstabilityandaidingmobility.2.2Classifyjointsusingthefollowingcriteria–relativeamountofmovementavailableandstructure:- Fibrous(suture,syndesmosis)

§ Fibrousmaterialjoinsboneendstogether.Theamountofmovementavailabledependsonlengthoffibres(longer=moremovement).

§ Sutures(immovable):betweenthebonesoftheskull§ Syndesmosis(slightlymovable):betweenradiusandulnaofforearm

PHTY100Semester1Notes–SarahCrisafulli 5

- Cartilaginous(primary/synchondrosis,secondary/symphysis)§ Cartilaginousmaterialjoinsboneendstogether.Amountofmovementavailabledependsontypeofcartilage:§ Primarycartilaginous/synchondrosis(immovable):unitedbyhyalinecartilage,canbepermanenti.e.ribsortemporaryi.e.

growthplates§ Secondarycartilaginous/symphysis(slightlymovable):articulatingbonescoveredwithhyalinecartilageandattached

togetherbylayer/discoffibrocartilagee.g.intervertebraljointsbetweenvertebrae- Synovial(freelymovable)

§ Boneendsshapedtofitoneanother,andcoveredwitharticularcartilage,whichallowsbonestoslideononeanother.§ Jointcavitycontainssynovialfluid(tonourishandlubricate)toassistfrictionlessmovementofbones,actsasapotential

space.§ Fibrousjointcapsuleunitesbonesandmaintainsjointcavity-reinforcedbycapsularligaments.§ Synovialmembranelinesfibrouscapsuleandproducessynovialfluid=nourishesandlubricates§ 2layers:innermembraneandfibrouscapsule

2.3Furtherclassifysynovialjointsby:- Degreesoffreedom;accordingtonumberofaxesaboutwhichmovementoccurs

§ Uniaxial–onepairofmovementse.g.elbow§ Biaxial–twopairsofmovementse.g.knee§ Multiaxial–threepairsofmovementse.g.shoulder)

- StructureDegreeoffreedom

Structure Description Example

Uniaxial Hinge Surfacesarrangedtoonlyallowonemovement.Goodarticularfit,supportedbystrongcollateralligaments

Elbow

Pivot Articularsurfacesarrangessoonebonerotateswithinfibro-osseousring

Superiorradio-ulnajoint

Biaxial Ellipsoid Anotherformofaballandsocketjoint,yetsurfacesellipsoidinnature

Radio-carpaljoint(flex/extend,adduct/abduct)

Condyloid Modifiedballandsocketjoint.Passivemovementmayoccuraboutthirdaxis

Metacarpophalangealjoints

Saddle Surfacesreciprocallyconcavo-convex.Principlemovementaboutperpendicularaxesbutsmallinthird

Carpo-metacarpaljointinthumb

Multiaxial Ballandsocket Ballofonebonefitsintosocketofanother HipandshoulderPlane Flatjointsurfaces,ofapproximatelyequal

extent.Movementeithersingleglidingortwistingwithinnarrowlimits

Acromioclavicularjoint

2.6UnderstandthestructureofandlistthefunctionsofligamentsBandsofdense,regularconnectivetissuethatattachonebonetoanother,variableinsize,shapeandorientationoffibres.Functions–actasmechanicalconstraintstopreventunwantedmovementandallowlimitedmovements,proprioceptioninsensoryorgansi.e.topreventrollingankles.2.7Understandtheclassificationofligamentsascapsular,extracapsularandintracapsularInsynovialjoints:capsular(bandsformpartofcapsuleforreinforcemente.g.iliofemoral),extracapsular(lieoutsidecapsule,limitunwantedmovemente.g.fibularcollateralligamentofknee)andintracapsular(lieinsidecapsulee.g.ACLandPCL)2.9UnderstandthestructureofandlistthefunctionsofarticulardiscsPadsoffibrocartilagesituatedbetweenarticularsurfacesofsomesynovialjoints,theirfunctionsare:

→ Actasshockabsorberse.g.betweenvertebrae→ Aidmechanicalfitbetweenarticularsurfaces→ Restrainmovemente.g.menisciinkneepreventbonesslidingagainsteachother→ Assistlubrication→ Permitdifferentmovementstooccursimultaneouslyinonejointe.g.temporo-mandibularjointinjaw,separatesintoupper

(protrusion)andlower(bite)2.10UnderstandthestructureofandlistthefunctionsofbursaeFluidfilledsacslinedwithsynovialmembrane,whichactsaspotentialspace.Functions–↓frictionasstructuresslideononeanother,thuslocatedbetweenlayersofmuscles/wheremusclesandtendonsoverliebonyprominences.2.11Describethe3principalaxesofmovementaboutsynovialjoints

1. Anteroposterioraxis(fronttoback)2. Transverseaxis(sidetoside)3. Longitudinalaxis(alonglengthofbone)